Evaluation of the optimal dosage of S-1 in adjuvant SOX chemotherapy for gastric cancer

Yang,Lin; Yang,Yi; Qin,Qiong; Zhou,Aiping; Zhao,Jianjun; Wang,Jinwan; Shu,Chang; Yuan,Xinghua; Hu,Songnian

doi:10.3892/ol.2014.2821

March-2015 Volume 9 Issue 3

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March-2015 Volume 9 Issue 3

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Article

Evaluation of the optimal dosage of S-1 in adjuvant SOX chemotherapy for gastric cancer

Authors:
- Lin Yang
- Yi Yang
- Qiong Qin
- Aiping Zhou
- Jianjun Zhao
- Jinwan Wang
- Chang Shu
- Xinghua Yuan
- Songnian Hu
View Affiliations / Copyright

Affiliations: Chinese Academy of Medical Sciences, Cancer Institute and Hospital, Beijing 100021, P.R. China, Chinese Academy of Sciences, Beijing Institute of Genomics, Beijing 100101, P.R. China
Pages: 1451-1457
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Published online on: December 22, 2014

https://doi.org/10.3892/ol.2014.2821
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Abstract

Gastric cancer (GC) is the second leading cause of cancer‑related mortality worldwide. The usual treatment of GC consists of surgery with additional adjuvant chemotherapy. In the present study, the feasibility and safety of adjuvant S‑1 plus oxaliplatin (SOX) chemotherapy for patients with GC and the optimal dosage of S‑1 were determined. Eligible patients were randomly assigned to either arm A (30 cases) receiving 70 mg/m2 S‑1 (in two seperate half doses) daily or arm B (30 cases) receiving 80 mg/m2 S‑1 (in two seperate half doses) daily. The S-1 was administered twice daily for 14 days followed by a 7‑day rest period for the third week. A total of 130 mg/m2 oxaliplatin was administered on day 1 every 3 weeks for each arm. The cumulative rates of the relative total administration dose of S‑1 at 100% in the 6th treatment course was 71.4% [95% confidence interval (CI), 56.5‑90.3%] in arm A, which was significantly higher than 21.4% (95% CI, 10.5‑43.6%) in arm B (P=0.001). The most common grade 3/4 toxicities were neutropenia (19.6%), thrombocytopenia (19.6%) and vomiting (16.1%). Grade 3/4 thrombocytopenia was observed in 7.1% of patients in arm A and in 32.1% of patients in arm B (P=0.019). With regard to the adverse events induced by S‑1 administration, the incidence of diarrhea (3.6 vs. 42.9%; P<0.001) was significantly higher in arm B than in arm A, as anticipated. Collectively, adjuvant SOX therapy for GC is feasible and safe, and when combined with 130 mg/m2 oxaliplatin, 70 mg/m2/day S‑1 appears to the optimal dose.

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1	Zhao P, Dai M, Chen W and Li N: Cancer trends in China. Jpn J Clin Oncol. 40:281–285. 2010. View Article : Google Scholar : PubMed/NCBI
2	Parkin DM, Bray F, Ferlay J and Pisani P: Global cancer statistics, 2002. CA Cancer J Clin. 55:74–108. 2005. View Article : Google Scholar : PubMed/NCBI
3	Gunderson LL: Gastric cancer - patterns of relapse after surgical resection. Semin Radiat Oncol. 12:150–161. 2002. View Article : Google Scholar : PubMed/NCBI
4	Gallo A and Cha C: Updates on esophageal and gastric cancers. World J Gastroenterol. 12:3237–3242. 2006.PubMed/NCBI
5	Mari E, Floriani I, Tinazzi A, et al: Efficacy of adjuvant chemotherapy after curative resection for gastric cancer: a meta-analysis of published randomised trials. A study of the GISCAD (Gruppo Italiano per lo Studio dei Carcinomi dell’Apparato Digerente). Ann Oncol. 11:837–843. 2000. View Article : Google Scholar : PubMed/NCBI
6	Earle CC and Maroun JA: Adjuvant chemotherapy after curative resection for gastric cancer in non-Asian patients: revisiting a meta-analysis of randomised trials. Eur J Cancer. 35:1059–1064. 1999. View Article : Google Scholar : PubMed/NCBI
7	Sasako M, Sakuramoto S, Katai H, et al: Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer. J Clin Oncol. 29:4387–4393. 2011. View Article : Google Scholar : PubMed/NCBI
8	Koizumi W, Narahara H, Hara T, et al: S-1 plus cisplatin versus S-1 alone for first-line treatment of advanced gastric cancer (SPIRITS trial): a phase III trial. Lancet Oncol. 9:215–221. 2008. View Article : Google Scholar : PubMed/NCBI
9	Cunningham D, Starling N, Rao S, et al: Upper Gastrointestinal Clinical Studies Group of the National Cancer Research Institute of the United Kingdom: Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 358:36–46. 2008. View Article : Google Scholar : PubMed/NCBI
10	Higuchi K, Koizumi W, Yamada Y, et al: Randomized phase III study of S-1 plus oxaliplatin versus S-1 plus cisplatin for first-line treatment of advanced gastric cancer. J Clin Oncol. 31(Suppl 4): astr 60. 2013.
11	Yang L, Song Y, Zhou AP, et al: A phase II trial of oxaliplatin plus S-1 as a first-line chemotherapy for patients with advanced gastric cancer. Chin Med J (Engl). 126:3470–3474. 2013.
12	Koizumi W, Takiuchi H, Yamada Y, et al: Phase II study of oxaliplatin plus S-1 as first-line treatment for advanced gastric cancer (G-SOX study). Ann Oncol. 21:1001–1005. 2010. View Article : Google Scholar
13	Narahara H, Iishi H, Imamura H, et al: Randomized phase III study comparing the efficacy and safety of irinotecan plus S-1 with S-1 alone as first-line treatment for advanced gastric cancer (study GC0301/TOP-002). Gastric Cancer. 14:72–80. 2011. View Article : Google Scholar : PubMed/NCBI
14	Yang L, Yang Y, Qin Q, et al: Dose-finding study on adjuvant chemotherapy with S-1 plus oxaliplatin for gastric cancer. Mol Clin Oncol. 2:93–98. 2014.PubMed/NCBI
15	Edge S, Byrd DR, Compton CC, et al: AJCC Cancer Staging Manual. 7th edition. Springer; New York, NY: 2009
16	Oken MM, Creech RH, Tormey DC, et al: Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 5:649–655. 1982. View Article : Google Scholar : PubMed/NCBI
17	National Cancer Institute. Common Terminology Criteria for Adverse Events [v.4.03]. http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf. Accessed June 11, 2011
18	Schulz KF, Altman DG and Moher D: CONSORT Group: CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. PLoS Med. 7:e10002512014. View Article : Google Scholar
19	Nakajima T, Nashimoto A, Kitamura M, et al: Adjuvant mitomycin and fluorouracil followed by oral uracil plus tegafur in serosa-negative gastric cancer: a randomised trial. Gastric Cancer Surgical Study Group. Lancet. 354:273–277. 1999. View Article : Google Scholar : PubMed/NCBI
20	Nakajima T, Takahashi T, Takagi K, Kuno K and Kajitani T: Comparison of 5-fluorouracil with ftorafur in adjuvant chemotherapies with combined inductive and maintenance therapies for gastric cancer. J Clin Oncol. 2:1366–1371. 1984.PubMed/NCBI
21	Nashimoto A, Nakajima T, Furukawa H, et al: Gastric Cancer Surgical Study Group, Japan Clinical Oncology Group: Randomized trial of adjuvant chemotherapy with mitomycin, Fluorouracil, and Cytosine arabinoside followed by oral Fluorouracil in serosa-negative gastric cancer: Japan Clinical Oncology Group 9206-1. J Clin Oncol. 21:2282–2287. 2003. View Article : Google Scholar : PubMed/NCBI
22	Kodera Y, Ishiyama A, Yoshikawa T, et al: Chubu Clinical Cancer Group: A feasibility study of postoperative chemotherapy with S-1 and cisplatin (CDDP) for gastric carcinoma (CCOG0703). Gastric Cancer. 13:197–203. 2010. View Article : Google Scholar : PubMed/NCBI
23	Kang BW, Kim JG, Chae YS, et al: Pilot study of adjuvant chemotherapy with 3-week combination of S-1 and cisplatin for patients with stage II–IV (M0) gastric cancer. Invest New Drugs. 30:1671–1675. 2012. View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Evaluation of the optimal dosage of S-1 in adjuvant SOX chemotherapy for gastric cancer

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